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Fill in this information to identify your case: 

United States Bankruptcy Court for the: 

NORTHERN DISTRICT OF ILLINOIS 

Case number (if known) Chapter you are filing under: 

■ Chapter 7 

❑ Chapter 11 

❑ Chapter 12 

❑ Chapter 13 ❑ Check if this an 

amended filing 

Official Form 101 

Voluntary Petition for Individuals Filing for Bankruptcy 12/15 

The bankruptcy forms use you and Debtor 1 to refer to a debtor filing alone. A married couple may file a bankruptcy case together—called a joint 

case—and in joint cases, these forms use you to ask for information from both debtors. For example, if a form asks, "Do you own a car," the answer 

would be yes if either debtor owns a car. When information is needed about the spouses separately, the form uses Debtor 1 and Debtor 2 to distinguish 

between them. In joint cases, one of the spouses must report information as Debtor 1 and the other as Debtor 2. The same person must be Debtor 1 in 

all of the forms. 

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. If 

more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer 

every question. 

Part 1: Identify Yourself 

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case): 

1. Your full name 

Write the name that is on Teia 

your government-issued First name First name 

picture identification (for 

example, your driver's M. 

license or passport). Middle name Middle name 

Bring your picture 

identification to your 

meeting with the trustee. 

Thompson 

Last name and Suffix (Sr., Jr., II, Ill) Last name and Suffix (Sr., Jr., II, Ill) 

2. All other names you have 

used in the last 8 years 

Include your married or 

maiden names. 

3. Only the last 4 digits of 

your Social Security 

number or federal 

Individual Taxpayer 

Identification number 

(ITIN) 

xxx-xx-4898 

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 1 

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■ Over the last 180 days before filing this petition, 

I have lived in this district longer than in any 

other district. 

❑ Over the last 180 days before filing this petition, I 

have lived in this district longer than in any other 

district. 

6. Why you are choosing 

this district to file for 

bankruptcy 

Check one: Check one: 

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Debtor 1 Teia M. Thompson Case number (if known) 

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case): 

4. Any business names and 

Employer Identification 

Numbers (EIN) you have 

used in the last 8 years 

■ I have not used any business name or EINs. ❑ I have not used any business name or EINs. 

Include trade names and 

doing business as names 

Business name(s) Business name(s) 

EINs EINs 

5. Where you live If Debtor 2 lives at a different address: 

10015 S. Vernan AVe. 

Chicago, IL 60628 

Number, Street, City, State & ZIP Code Number, Street, City, State & ZIP Code 

Cook 

County County 

If your mailing address is different from the one 

above, fill it in here. Note that the court will send any 

notices to you at this mailing address. 

If Debtor 2's mailing address is different from yours, fill it 

in here. Note that the court will send any notices to this 

mailing address. 

Number, P.O. Box, Street, City, State & ZIP Code Number, P.O. Box, Street, City, State & ZIP Code 

❑ I have another reason. ❑ I have another reason. 

Explain. (See 28 U.S.C. § 1408.) Explain. (See 28 U.S.C. § 1408.) 

page 2 Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy 

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Debtor 1 Teia M. Thompson Case number (if known) 

En Tell the Court About Your Bankruptcy Case 

7. The chapter of the Check one. (For a brief description of each, see Notice Required by 11 U.S.C. § 342(b) for Individuals Filing for Bankruptcy 

Bankruptcy Code you are (Form 2010)). Also, go to the top of page 1 and check the appropriate box. 

choosing to file under ■ Chapter 7 

❑ Chapter 11 

❑ Chapter 12 

❑ Chapter 13 

8. How you will pay the fee ■ I will pay the entire fee when I file my petition. Please check with the clerk's office in your local court for more details 

about how you may pay. Typically, if you are paying the fee yourself, you may pay with cash, cashier's check, or money 

order. If your attorney is submitting your payment on your behalf, your attorney may pay with a credit card or check with 

a pre-printed address. 

• need to pay the fee in installments. If you choose this option, sign and attach the Application for Individuals to Pay 

The Filing Fee in Installments (Official Form 103A). 

❑ I request that my fee be waived (You may request this option only if you are filing for Chapter 7. By law, a judge may, 

but is not required to, waive your fee, and may do so only if your income is less than 150% of the official poverty line that 

applies to your family size and you are unable to pay the fee in installments). If you choose this option, you must fill out 

the Application to Have the Chapter 7 Filing Fee Waived (Official Form 103B) and file it with your petition. 

9. Have you filed for 

bankruptcy within the 

last 8 years? 

■ No . 

❑ Yes. 

District When Case number 

District When Case number 

District When Case number 

10. Are any bankruptcy 

cases pending or being 

filed by a spouse who is 

not filing this case with 

you, or by a business 

partner, or by an 

affiliate? 

■ No 

❑ Yes. 

Relationship to you 

Case number, if known 

Relationship to you 

Case number, if known 

11. Do you rent your 

residence? 

■ No. 

❑ Yes. 

Go to line 12. 

Has your landlord obtained an eviction judgment against you and do you want to stay in your residence? 

❑ No. Go to line 12. 

❑ Yes. Fill out Initial Statement About an Eviction Judgment Against You (Form 101A) and file it with this 

bankruptcy petition. 

Debtor 

District 

Debtor 

District 

When 

When 

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Debtor 1 Teia M. Thompson Case number (if known) 

Part 3: Report About Any Businesses You Own as a Sole Proprietor 

12. Are you a sole proprietor 

of any full- or part-time 1111 No. 

business? 

❑ Yes . 

A sole proprietorship is a 

business you operate as 

an individual, and is not a 

separate legal entity such 

as a corporation, 

partnership, or LLC. 

If you have more than one 

sole proprietorship, use a 

separate sheet and attach 

it to this petition. 

Go to Part 4. 

Name and location of business 

Name of business, if any 

Number, Street, City, State & ZIP Code 

Check the appropriate box to describe your business: 

❑ Health Care Business (as defined in 11 U.S.C. § 101(27A)) 

❑ Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B)) 

❑ Stockbroker (as defined in 11 U.S.C. § 101(53A)) 

❑ Commodity Broker (as defined in 11 U.S.C. § 101(6)) 

❑ None of the above 

13. Are you filing under 

Chapter 11 of the 

Bankruptcy Code and are 

you a small business 

debtor? 

If you are filing under Chapter 11, the court must know whether you are a small business debtor so that it can set appropriate 

deadlines. If you indicate that you are a small business debtor, you must attach your most recent balance sheet, statement of 

operations, cash-flow statement, and federal income tax return or if any of these documents do not exist, follow the procedure 

in 11 U.S.C. 1116(1)(B). 

For a definition of small 

business debtor, see 11 

U.S.C. § 101(51D). 

■ No . 

❑ No 

❑ Yes . 

I am not filing under Chapter 11 . 

I am filing under Chapter 11, but I am NOT a small business debtor according to the definition in the Bankruptcy 

Code. 

I am filing under Chapter 11 and I am a small business debtor according to the definition in the Bankruptcy Code. 

Part 4: Report if You Own or Have Any Hazardous Property or Any Property That Needs Immediate Attention 

14. Do you own or have any 

property that poses or is 

alleged to pose a threat 

of imminent and 

identifiable hazard to 

public health or safety? 

Or do you own any 

property that needs 

immediate attention? 

■ No. 

❑ Yes . 

What is the hazard? 

If immediate attention is 

needed, why is it needed? 

For example, do you own 

perishable goods, or 

livestock that must be fed, 

or a building that needs 

urgent repairs? 

Where is the property? 

Number, Street, City, State & Zip Code 

Voluntary Petition for Individuals Filing for Bankruptcy page 4 

Official Form 101 

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Debtor 1 Teia M. Thompson 

Part 5: Explain Your Efforts to Receive a Briefing About Credit Counseling 

Case number Of known) 

About Debtor 1: 

15. Tell the court whether You must check one 

you have received a • I received a briefing from an approved credit 

briefing about credit counseling agency within the 180 days before I 

counseling. filed this bankruptcy petition, and I received a 

certificate of completion. 

Attach a copy of the certificate and the payment 

plan, if any, that you developed with the agency. 

❑ I received a briefing from an approved credit 

counseling agency within the 180 days before I 

filed this bankruptcy petition, but I do not have 

a certificate of completion. 

Within 14 days after you file this bankruptcy 

petition, you MUST file a copy of the certificate and 

payment plan, if any. 

❑ I certify that I asked for credit counseling 

services from an approved agency, but was 

unable to obtain those services during the 7 

days after I made my request, and exigent 

circumstances merit a 30-day temporary waiver 

of the requirement. 

To ask for a 30-day temporary waiver of the 

requirement, attach a separate sheet explaining 

what efforts you made to obtain the briefing, why 

you were unable to obtain it before you filed for 

bankruptcy, and what exigent circumstances 

required you to file this case. 

Your case may be dismissed if the court is 

dissatisfied with your reasons for not receiving a 

briefing before you filed for bankruptcy. 

If the court is satisfied with your reasons, you must 

still receive a briefing within 30 days after you file. 

You must file a certificate from the approved 

agency, along with a copy of the payment plan you 

developed, if any. If you do not do so, your case 

may be dismissed. 

Any extension of the 30-day deadline is granted 

only for cause and is limited to a maximum of 15 

days. 

❑ I am not required to receive a briefing about 

credit counseling because of: 

❑ Incapacity. 

I have a mental illness or a mental deficiency 

that makes me incapable of realizing or 

making rational decisions about finances. 

❑ Disability. 

My physical disability causes me to be 

unable to participate in a briefing in person, 

by phone, or through the internet, even after I 

reasonably tried to do so. 

❑ Active duty. 

I am currently on active military duty in a 

military combat zone. 

If you believe you are not required to receive a 

briefing about credit counseling, you must file a 

motion for waiver credit counseling with the court. 

About Debtor 2 (Spouse Only in a Joint Case): 

You must check one: 

❑ I received a briefing from an approved credit 

counseling agency within the 180 days before I filed 

this bankruptcy petition, and I received a certificate of 

completion. 

Attach a copy of the certificate and the payment plan, if 

any, that you developed with the agency. 

❑ I received a briefing from an approved credit 

counseling agency within the 180 days before I filed 

this bankruptcy petition, but I do not have a certificate 

of completion. 

Within 14 days after you file this bankruptcy petition, you 

MUST file a copy of the certificate and payment plan, if 

any. 

❑ I certify that I asked for credit counseling services 

from an approved agency, but was unable to obtain 

those services during the 7 days after I made my 

request, and exigent circumstances merit a 30-day 

temporary waiver of the requirement. 

To ask for a 30-day temporary waiver of the requirement, 

attach a separate sheet explaining what efforts you made 

to obtain the briefing, why you were unable to obtain it 

before you filed for bankruptcy, and what exigent 

circumstances required you to file this case. 

Your case may be dismissed if the court is dissatisfied 

with your reasons for not receiving a briefing before you 

filed for bankruptcy. 

If the court is satisfied with your reasons, you must still 

receive a briefing within 30 days after you file. You must 

file a certificate from the approved agency, along with a 

copy of the payment plan you developed, if any. If you do 

not do so, your case may be dismissed. 

Any extension of the 30-day deadline is granted only for 

cause and is limited to a maximum of 15 days. 

❑ I am not required to receive a briefing about credit 

counseling because of: 

❑ Incapacity. 

I have a mental illness or a mental deficiency that 

makes me incapable of realizing or making rational 

decisions about finances. 

❑ Disability. 

My physical disability causes me to be unable to 

participate in a briefing in person, by phone, or 

through the internet, even after I reasonably tried to 

do so. 

❑ Active duty. 

I am currently on active military duty in a military 

combat zone. 

If you believe you are not required to receive a briefing 

about credit counseling, you must file a motion for waiver 

of credit counseling with the court. 

The law requires that you 

receive a briefing about 

credit counseling before 

you file for bankruptcy. 

You must truthfully check 

one of the following 

choices. If you cannot do 

so, you are not eligible to 

file. 

If you file anyway, the court 

can dismiss your case, you 

will lose whatever filing fee 

you paid, and your 

creditors can begin 

collection activities again. 

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 5 

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Debtor 1 Teia M. Thompson Case number (if known) 

Part 6: Answer These Questions for Reporting Purposes 

16. What kind of debts do 

you have? 

16a. Are your debts primarily consumer debts? Consumer debts are defined in 11 U.S.C. § 101(8) as "incurred by an 

individual primarily for a personal, family, or household purpose." 

❑ No. Go to line 16b. 

■ Yes. Go to line 17. 

16b. Are your debts primarily business debts? Business debts are debts that you incurred to obtain 

money for a business or investment or through the operation of the business or investment. 

❑ No. Go to line 16c. 

❑ Yes. Go to line 17. 

16c. State the type of debts you owe that are not consumer debts or business debts 

❑ No. I am not filing under Chapter 7. Go to line 18. 

■ Yes . 

I am filing under Chapter 7. Do you estimate that after any exempt property is excluded and administrative expenses 

are paid that funds will be available to distribute to unsecured creditors? 

■ No 

❑ Yes 

• 1-49 

❑ 50-99 

❑ 100-199 

❑ 200-999 

❑ 

❑ 

❑ 

1,000-5,000 

5001-10,000 

10,001-25,000 

❑ 25,001-50,000 

❑ 50,001-100,000 

❑ More than100,000 

❑ $0 - $50,000 ❑ $1,000,001 - $10 million ❑ $500,000,001 - $1 billion 

■ $50,001 - $100,000 ❑ $10,000,001 - $50 million ❑ $1,000,000,001 -$10 billion 

❑ $100,001 - $500,000 ❑ $50,000,001 - $100 million ❑ $10,000,000,001 - $50 billion 

❑ $500,001 - $1 million ❑ $100,000,001 - $500 million ❑ More than $50 billion 

❑ $0 - $50,000 ❑ $1,000,001 - $10 million ❑ $500,000,001 - $1 billion 

❑ $50,001 - $100,000 ❑ $10,000,001 - $50 million ❑ $1,000,000,001 - $10 billion 

■ $100,001 - $500,000 ❑ $50,000,001 - $100 million ❑ $10,000,000,001 - $50 billion 

❑ $500,001 - $1 million ❑ $100,000,001 - $500 million ❑ More than $50 billion 

17. Are you filing under 

Chapter 7? 

Do you estimate that 

after any exempt 

property is excluded and 

administrative expenses 

are paid that funds will 

be available for 

distribution to unsecured 

creditors? 

18. How many Creditors do 

you estimate that you 

owe? 

19. How much do you 

estimate your assets to 

be worth? 

20. How much do you 

estimate your liabilities 

to be? 

Part 7: Sign Below 

For you I have examined this petition, and I declare under penalty of perjury that the information provided is true and correct. 

If I have chosen to file under Chapter 7, I am aware that I may proceed, if eligible, under Chapter 7, 11,12, or 13 of title 11, 

United States Code. I understand the relief available under each chapter, and I choose to proceed under Chapter 7. 

If no attorney represents me and I did not pay or agree to pay someone who is not an attorney to help me fill out this 

document, I have obtained and read the notice required by 11 U.S.C. § 342(b). 

I request -lief in accordance with the chapter of title 11, United States Code, specified in this petition. 

I unde tand making a false statement, concealing property, or obtaining money or property by fraud in connection with a 

ban uptcy case can result in fines up to $250,100, or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, 

and 571. 

Teia M. Thomason k4—"` ---- 

is M. Thompson Signature of Debtor 2 

ature of Debtor 1 

Executed on August 31, 2016 Executed on 

MM / DD / YYYY MM / DD / YYYY 

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 6 

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Debtor 1 Teia M. Thompson Case number (if known) 

8/31/16 9:13AM 

For your attorney, if you are 

represented by one 

If you are not represented by 

an attorney, you do not need 

to file this page. 

I, the attorney for the debtor(s) named in this petition, declare that I have informed the debtor(s) about eligibility to proceed 

under Chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief available under each chapter 

for which the person is eligible. I also certify that I have delivered to the debtor(s) the notice required by 11 U.S.C. § 342(b) 

and, in a case in which § 707(b)(4)(D) applies, certify that I have no knowledge after an inquiry that the information in the 

schedules filed with the petition is incorrect. 

Is/ Veronica D. Joyner, Esq. Date August 31, 2016 

Signature of Attorney for Debtor MM / DD / YYYY 

Veronica D. Joyner, Esq. 

Printed name 

Joyner Law Office, Inc. 

Firm name 

120 South Sate Street 

Suite 200 

Chicago, IL 60603 

Number, Street, City, State & ZIP Code 

Contact phone 312-332-9001 Email address vdjoyner@joynerlawoffice.com 

6239246 

Bar number & State 

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 7 

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In re Teia M. Thompson 

United States Bankruptcy Court 

Northern District of Illinois 

Case No. 

Debtor(s) Chapter 7 

VERIFICATION OF CREDITOR MATRIX 

Number of Creditors: 2 

The above-named Debtor(s) hereby verifies that the list of creditors is true and correct to the best of my 

(our) knowledge. 

Date: August 31, 2016 /s/ Teia M. Thompson_,.---`--1//------- 

Teia M. Thompson 

Signature of Debtor 

Software Copyright (c) 1996-2016 Best Case, LLC - www.bestcase.com Best Case Bankruptcy 

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Codilis & Assoicates 

15W030 North Frontage Rd 

Suite 100 

Burr Ridge, IL 60527 

Ocwen Loan Servicing 

P.O. Box 6440 

Carol Stream, IL 60197 

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